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Foon Rhee: Vets seek a path out of the darkness

Clutching his daughter's teddy bear for luck, T.J. Norton tried to keep it together for his graduation speech at the Pathway Home, a renowned program for troubled combat veterans.

He started thanking everyone, but had to stop and bow his head, struggling to hold back the tears. "It's just incredible the love and support here," he managed to get out.

He choked up again, until his 11-year-old daughter Claire came up to hug him and stand by his side. He vowed to "pay forward" what he had learned. "I'm going to do good things," he said, "I promise."

Adam Duncan, a fellow Army veteran from Sacramento, wept as he made his thank-yous, especially to his six fellow graduates, his "brothers."

"I think this place saved my life," he said softly. "And I know I didn't have a lot of time left out there on my own."

By this point, I and many in the audience of loved ones, staffers and local volunteers were wiping away our own tears.

Like me, you may have been saddened and stunned by the recent headline: A record 349 suicides last year in the active-duty military, many more deaths than in the Afghanistan war.

But the specter of suicide doesn't end once service members come home. It gets worse.

While precise numbers are hard to come by, suicide is taking more lives among vets – those who have recently returned and also those still struggling from wars long ago – than among current service members. A just-released government estimate is that 22 vets die by suicide every day – about 20 percent of all Americans who kill themselves.

Norton and Duncan told me they could easily have been part of those grim numbers.

Norton, 31, joined the Army in 2000 after high school and saw combat during a year in Iraq. Discharged in 2005, he returned to Sacramento and "spiraled downward," unable to find a job or get enough help from the U.S. Department of Veterans Affairs. He hit bottom last October and thought about suicide.

Duncan, 32, was in the Army for eight years, including three tours in Iraq. Discharged in 2008, he worked in oil fields in Utah, but was laid off and came back to Sacramento in 2011. His life "fell apart." He was homeless and jobless, and only his girlfriend Kiah stuck by him. When he tried to overdose on pills, he ended up in psychiatric intensive care at the VA's Mather clinic.

Both were sent to Pathway Home, a residential treatment program for Iraq and Afghanistan veterans that is referred some of the toughest cases from across the country – the ones the VA can't handle, the vets kicked out of programs for making threats or refusing to follow rules. Nearly all of them have either attempted suicide or thought about it.

During the four-month program, participants get the benefit of the most up-to-date thinking in treating combat stress, plus lots of compassion and patience. They go through 60 hours of trauma therapy, learn to deal with anger and get help to stop taking so many medications. They go bowling and fishing with local Rotary Club members, just one way the Napa Valley embraces the program.

After they graduate, vets receive weekly texts with a positive affirmation in their own words. They're asked how they're doing; if they indicate they're in distress, alerts immediately go out to therapists, relatives and friends.

What's also remarkable about Pathway Home is that it gets no government money. The nonprofit's annual budget of $1.2 million is entirely from foundation grants and private donations. It has been leasing space at the state Veterans Home in Yountville for $1 a year, and is now in negotiations with the state, which is seeking rent closer to the market rate, as much as $50,000 annually.

Since Pathway opened in January 2008, about 320 veterans have graduated. So far, only one has committed suicide, about two years after leaving, says Executive Director Fred Gusman, a veteran himself, who helped establish the VA's first residential treatment programs for post-traumatic stress. Pathway Home is just for men, though Gusman hopes to eventually accept female veterans.

But it has room for only 36 vets at a time. They're the lucky ones.

Though government agencies, advocacy groups and nonprofits are more aware of the suicide problem, experts say there aren't nearly enough mental health professionals, or enough coordination among programs.

"America is losing its battle against suicide by veterans and service members. And, as more troops return from deployment, the risk will only grow," says the Center for a New American Security, a Washington think tank. It warns that if military service becomes linked with suicide, it could make the all-volunteer force unworkable.

Suicide is one price of the wars in Iraq and Afghanistan. Traumatic brain injuries, stress from repeated deployments, unemployment at home and cuts in mental health programs all make recent vets more vulnerable to psychological problems, experts say.

Members of the National Guard returning from war zones face particular problems. Unlike active-duty service members who go back to their home bases, where they can talk to fellow troops and get counseling, Guard members get thrown back into their hometowns, often lose touch with fellow soldiers and can live far away from VA centers, military bases and other support.

Lt. Col. Susan Pangelinan, who coordinates the California National Guard's behavioral health program, says there should be a "buffer zone" to ease the transition back to civilian life. It could be funded like unemployment insurance or added to military demobilization, she testified at a Little Hoover Commission hearing last month on veterans' needs.

Thousands of members of the California National Guard, the nation's largest, have deployed since 9/11 to Iraq and Afghanistan. Pangelinan's program, which Guard officials say is their last line of defense against suicide, started in 2010 with $560,000 a year in Proposition 63 money. It had more than 7,400 contacts with Guard members last year.

Guard therapists respond 24/7 to crisis calls, stabilize those in trouble and refer those requiring further treatment to county mental health departments, the VA or private agencies. After suicides – there were three in one recent month – therapists counsel members of their units.

Nationally, the VA is ramping up its suicide prevention efforts as well.

Last August, President Barack Obama signed an executive order calling on the VA to guarantee that veterans in crisis are able to connect with a mental health worker within 24 hours. He ordered the agency to add 1,600 mental health professionals by June 30 and to hire 800 vets as peer counselors by Dec. 30. The VA also launched a "Stand by Them" public awareness campaign to encourage family and friends to help spot vets in trouble and steer them to mental health services.

These reinforcements are long overdue, but will they be enough? As many as 1 million more active-duty personnel are expected to leave the military in the next five years.

Definitely, there are too few places like Pathway Home. Gusman, its founder, likens it to a lighthouse that helps lost vets find safe harbor.

"They didn't quit on their comrades, and we don't quit on them," he said at the graduation ceremony in Yountville earlier this month.

Some veterans were badly damaged by what they saw or what they had to do in protecting us far from home. Too many are still searching in the darkness.

VETERANS AND SUICIDE

While complete statistics don't exist, the best available numbers indicate how widespread the problem is:

The U.S. Department of Veterans Affairs, using death records in 21 states, estimates that an average of 22 vets kill themselves every day.

The University of Chicago Center for Health Statistics says the youngest veterans, up to age 24, are nearly four times more likely to commit suicide than non-veterans in their age group.

The VA says that since launching its crisis line in 2007, it has answered more than 747,000 calls and prevented 26,000 suicides.

The California Office of Suicide Prevention says more than 12,000 Californians called the crisis line between January and July 2010.

Here are some resources for service members, veterans and their families:

U.S. Department of Veterans Affairs, crisis line for mental health treatment and referrals. (800) 273-8255. www.veteranscrisisline.net

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